The psycho-social challenges of working at the forefront of the Covid-19 pandemic : a survey of emergency care services personnel in the Eastern Cape EMS

Abstract

Introduction The COVID-19 pandemic, which emerged in early 2020, has caused a surge in patient numbers and crippled healthcare systems. South Africa has had more than 2.9 million positive COVID-19 cases, resulting in over 89 000 deaths. Healthcare workers (HCWs) have been under insurmountable mental and psychological pressure, leading to depression, anxiety and ultimately, burnout. Emergency Medical Services (EMS) personnel play a pivotal role in managing and caring for ill and injured patients in the pre-hospital setting. These practitioners are at the forefront of the fight against COVID-19. Despite the role they play in improving the health outcomes of these patients, there is a paucity of research on the effect of COVID-19 on EMS personnel working and living in the rural areas of low-and-middle-income countries like South Africa. Gaining insight into the daily challenges faced by HCWs and the coping strategies adopted will assist EMS personnel in mitigating physical and emotional stressors, as well as long-term psychological effects. Aim of the study To investigate the psycho-social influence of working at the forefront of the COVID-19 pandemic amongst EMS personnel in the Eastern Cape. Objectives This study aimed to: I. Identify the working conditions that exacerbate the stress of working within the context of the COVID-19 pandemic; II. Ascertain the factors that reduce stress amongst EMS personnel; III. Identify the psychological stressors amongst EMS personnel in the Eastern Cape during the COVID-19 pandemic; IV. Identify the coping mechanisms/strategies used by EMS personnel in the Eastern Cape during the COVID-19 pandemic; and V. Make recommendations on providing support and improving the working conditions of EMS personnel in the Eastern Cape. Methodology The study was conducted using a quantitative, cross-sectional descriptive survey design guided by a post-positivist paradigm with a deductive approach. Data was collected from 368 participants who worked in the Eastern Cape during the start of the COVID-19 pandemic. Participants were presented with an online survey questionnaire, which was subsequently analysed using the Statistical Package for the Social Sciences (SPSS) statistics software, and the results were presented by tables, charts and descriptive summaries. Results An overwhelming 80.4% (n=296) of EMS personnel showed dedication to their work (patient care), despite working under immense pressure. The findings showed moderate agreement to different stressors, indicating that EMS personnel do not suffer from existential fears but are somewhat worried about their own risk of infection and that of their family. The main stress factors included the availability of PPE, infection and treatment protocols, recognition of their work by EMS management, and the perceived risk of infection to themselves and others. Motivational factors that encourage EMS personnel to work in future outbreaks or pandemics were not significantly related to attitudes within the context of the COVID-19 pandemic. Conclusion As a direct and immediate consequence of providing care to COVID-19-infected patients, frontline HCWs put themselves at risk of various adverse physical and emotional effects. An already stressful situation becomes extremely precarious as a result of the escalating negative impacts on mental and physical health experienced by EMS personnel, a crucial demographic, used to fight the pandemic. The findings of this study are consistent with what was already known from previous studies conducted on HCWs during previous pandemics, thereby being relatively predictable. This emphasizes the importance of basing pandemic planning and reactions on the most current and reliable data.